ABSTRACT

Introduction

In the early 2000 s, investigators at the federal government noted growing Medicare expenditures for power mobility devices, which were related to high profit margins and fraudulent activity. Medicare responded with policy and program changes, and stakeholders in wheelchair service delivery have noticed an impact on their services and changes in wheelchair user access to needed equipment.

Methods

This study examined 4,252 wheelchair clinical recommendations made by full-time wheelchair seating department therapists between 2007 and 2017 through a retrospective chart review. Demographic counts and percentages were examined in relationship with equipment over time.

Results

The number of recommendations increased over time in all age groups, but most for people aged 19–64. Fifty percent of people with Medicare were younger than 65, and 63% of Medicare recommendations were for complex wheelchair bases. Overall, decreased recommendations were noted in 2008, consistent with the economic recession. An increase in recommendations occurred from 2014 to 2017, consistent with the onset of the Affordable Care Act.

Conclusions

Most change occurred for middle and older age groups, complex manual wheelchairs, and standard power mobility devices. This study supports the need for a separate Medicare category of Complex Rehabilitation Technology for those with severe disabilities.

中文翻译：

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专用座位部门的轮椅推荐趋势

摘要

介绍

在 2000 年代初期，联邦政府的调查人员注意到医疗保险对电动移动设备的支出不断增长，这与高利润率和欺诈活动有关。Medicare 以政策和计划的变化作为回应，轮椅服务提供的利益相关者已经注意到对其服务的影响以及轮椅用户使用所需设备的变化。

方法

本研究通过回顾性图表审查，检查了 2007 年至 2017 年间全职轮椅座椅治疗师提出的 4,252 条轮椅临床建议。随着时间的推移，人口统计和百分比与设备的关系进行了检查。

结果

随着时间的推移，所有年龄组的建议数量都在增加，但大多数是针对 19-64 岁的人群。50% 的 Medicare 患者年龄在 65 岁以下，63% 的 Medicare 建议针对的是复杂的轮椅底座。总体而言，与经济衰退一致，2008 年的建议有所减少。从 2014 年到 2017 年，建议有所增加，这与平价医疗法案的实施一致。

结论

大多数变化发生在中老年组、复杂的手动轮椅和标准动力移动设备上。这项研究支持需要为严重残疾的人设立一个单独的医疗保险类别的复杂康复技术。